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APRI Calculator

Item: APRI Calculator
Rating: 4.9
Author: Fitelo

The APRI Calculator is a non-invasive alternative to liver biopsy, designed to assess hepatic fibrosis and cirrhosis. It provides an AST to Platelet Ratio Index (APRI) score using routine blood test parameters. Initially validated for patients with chronic hepatitis C (CHC), the APRI is now widely used to evaluate other liver diseases. Unlike liver biopsies, this method avoids patient discomfort and reduces the risk of complications.

AST to Platelet Ratio Index

APRI score -

APRI score interpretation:

Significant fibrosis: APRI threshold of 0.7 (77% sensitive and 72% specific);
Severe fibrosis: APRI threshold of 1.0 (61% sensitive and 64% specific);
Cirrhosis: APRI threshold of 1.0 (76% sensitive and 72% specific).

The APRI score has no universal cut-off values, as it is not sufficiently sensitive to rule out significant diseases (especially with midrange values).
The lower the APRI score (<0.5), the greater the negative predictive value and ability to rule out cirrhosis.

The higher the value (>1.5), the greater the positive predictive value and ability to rule in cirrhosis.

How to Use the Calculator

To calculate the APRI score, you will need three values from recent laboratory tests:

AST Level (IU/L): The aspartate aminotransferase level of the patient.
AST Upper Limit (IU/L): The standard threshold for AST, usually set at 40 IU/L. This value can be adjusted as needed.
Platelet Count (×10⁹/L): The patient’s platelet count.

The formula for the APRI score is: APRI = [(AST level / AST upper limit) / Platelet count] × 100

For example, if a patient’s AST level is 110 IU/L, the AST upper limit is 40 IU/L, and the platelet count is 110×10⁹/L, the calculation is:

APRI = [(AST level / AST upper limit) / Platelet count] × 100
APRI = [(110 / 40) / 110] × 10
APRI = [2.75 / 110] × 100
APRI = 0.025 × 100
APRI = 2.5

This patient likely has severe fibrosis or cirrhosis.

What’s a Healthy or Unhealthy APRI Score?

The APRI score is interpreted as follows:

Significant fibrosis: APRI threshold of 0.7 (77% sensitive and 72% specific);
Severe fibrosis: APRI threshold of 1.0 (61% sensitive and 64% specific); and
Cirrhosis: APRI threshold of 1.0 (76% sensitive and 72% specific).

Key Notes:

Low APRI (0.5): High negative predictive value, ruling out cirrhosis.
High APRI (>1.5): High positive predictive value, suggesting cirrhosis.
Midrange values may require further diagnostic testing.

Why Use This Calculator?

Non-Invasive Diagnostic Tool: Avoids the risks and discomfort of liver biopsies.
Early Detection: Identifies significant fibrosis and cirrhosis promptly.
Widely Applicable: Useful for diagnosing various liver diseases beyond CHC.
Accessible and Convenient: Requires only routine blood test parameters.